Obstetrics safety initiatives cut medical liability costs by 90%

Obstetrics patient safety initiatives at New York-Presbyterian Hospital/Weill Cornell Medical Center significantly reduced staff errors and cut medical liability expenses by more than 90%, according to a study.

The study, published in the February issue of the American Journal of Obstetrics & Gynecology, found that patient safety measures lowered medical liability compensation for the hospital overall from an average of $27.6 million a year from 2003 to 2006 to an average of $2.6 million from 2007 to 2009 (link). The figure for 2009 was only $250,000.

The compensation payments were defined as all legal settlements, jury awards and defense expenses.

Sentinel events at the medical center, including maternal deaths and serious newborn injuries, went from five in 2000 to zero in 2008 and 2009, the study showed.

The patient safety efforts started after consultants accessed the hospital's obstetrics department. From 2003 to 2009, the department began various safety plans based on the assessment.

Those measures included mandatory team-communication training for all medical staff, electronic medical records adoption and development of online communication resources for staff. The hospital also funded a patient safety nurse, additional physician assistants and a physician whose focus is managing patients in labor.

"The main goal of these changes was to improve patient safety and decrease adverse outcomes," the study's authors wrote. "We did not expect a rapid and significant effect on compensation payments."

In 2005, the hospital's legal and obstetrics departments created an early identification program for adverse outcomes and potential liability cases.

If a medical error is identified, the team approaches the patient with the goal of an early settlement, according to the study. Since the early-identification program started, one adverse outcome has been indentified and quickly settled, the study said.

Teamwork and communication were the foundation of the safety program, the study's authors said.

"Poor communication is among the most cited reasons for malpractice suits," they said. "In our opinion, the documented success of our patient safety improvement program in decreasing compensation payments ... understates the true long-term impact of the program on patient safety, as we expect significant savings to continue into the future."